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[Treatment] My Doctor Didn't Check For Compliance
#1
My Doctor Didn't Check For Compliance
I moved to a new state a few years ago and had to find a new sleep doctor. There is a local neurologist, in network, that specializes in sleep disorders. First time I saw him he took the data from my ResMed S9 sdcard, and made sure my prescriptions were renewed.

Second time I went back I saw the nurse instead. The nurse had no idea about compliance, nor what the sdcard data was all about. He didn't check for compliance. I thought that was odd.

Now I'm scheduled to go back for my third visit and my insurance says I'm due for a new CPAP machine if I want one. After my last visit, I'm not sure I'm seeing the right guy. He should be able to write me a new prescription. I guess I should call ahead and ask about it.

My last neurologist was very adamant about checking compliance.

Anyone else have experiences like this? Should I change doctors?

Thanks in advance for any and all advice.
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#2
RE: My Doctor Didn't Check For Compliance
My understanding is that the insurance companies are only really concerned about compliance for the first 90 days (correct me if I'm wrong). It's easy enough to check for compliance either on the machine's screen or software such as Oscar, ResScan et al. Or you can just ask the patient how it's going. Perhaps your guy did this without making a song & dance about it.

So my question to you is "How is it going"? Do you get refreshing sleep? Do you use the machine regularly? What's your normal AHI? Why is your machine still set to 4 - 20 cmH2O when a narrower range is typically more efficacious for most people?

Do you really need a sleep doctor other than for a prescription?
DeepBreathing
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: My Doctor Didn't Check For Compliance
"Compliance" only has meaning in the insurance coding and reimbursement industries for the most part.

If you are using it and it's working, why would you care if they checked "compliance"?

Unless it's theater.
There.  I said it.

OMMOHY
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#4
RE: My Doctor Didn't Check For Compliance
I guess I'm a little concerned that my new doctor is just giving me the fast-track checkup to get me on my way and collect the insurance payment for the office visit. I'll go in next week with a bunch of questions. The last doctor I had before I moved would always check the data off the sd card and comment on my compliance and how the data looked.

Overall, I'm doing well. The ResMed never got any adjustments since I got it about 5 years ago. My AHI for the last six months is averaging 3.51. I'm sleeping a lot better than before I got it. I was lucky to average 4 hours of sleep per night before treatment. I think I could do better though.

My plan is to ask my new doctor some specific questions and see how he answers. If I'm not satisfied, then it's time for a change. We'll see.

I'm having an issue with the OSCAR import now and I just posted on the Software forum.

Looking forward to being active on these forums.
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#5
RE: My Doctor Didn't Check For Compliance
You're not alone. My doctor never asked about data in the 10 years I saw him. The last 3 years I've seen the nurse practitioner. She's a little more interested but not in much more than my AHI. I mentioned bringing my SD card and was told she had no way to read it.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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#6
RE: My Doctor Didn't Check For Compliance
Since being past the compliance stage, my pulmonary doc only asks how my ASV is working for me. He also checks my COPD status and inhaler meds at that time. He doesn’t concern himself with my ASV settings, yet he’s aware I control my own.
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

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#7
RE: My Doctor Didn't Check For Compliance
My recommendation is to advocate for yourself. Use your APP that comes with your machine, OSCAR and maybe a Fitbit. This is what I use. You will learn more as you use this forum from folks with lots of experience. I found that my "care givers" didn't really care too much, nor were they very helpful or knowledgeable. (My NP tried to put me on drugs to fix my "sensitivity" to using the machine,Y OTHER OPTION,) I refused and started looking at options. Turns out my fixed pressure was not strong enough, so was torture. I woke up every hour. I had been an excellent sleeper before CPAP. I asked for a variable pressure and it began to make all the difference. Anyway, long story short, if you are have good results, continue to use your APP and Oscar to see how you are doing. If you have a good AHi and you are sleeping well, you are doing just fine.
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